malaysian generation y’s acceptance level towards...

MALAYSIAN GENERATION Y’S ACCEPTANCE LEVEL TOWARDS COSMETIC SURGERY

KEE CIA HEE

MASTER OF BUSINESS ADMINISTRATION (CORPORATE GOVERNANCE)

UNIVERSITI TUNKU ABDUL RAHMAN

FACULTY OF ACCOUNTANCY AND MANAGEMENT

AUGUST 2017

KEE CIA HEE COSMETIC SURGERY MBA (CG) AUGUST 2017

Malaysian Generation Y‘s Acceptance Level Towards

Cosmetic Surgery

Kee Cia Hee

A research project submitted in partial fulfillment of the

requirement for the degree of

Master of Business Administration (Corporate Governance)

Universiti Tunku Abdul Rahman

Faculty of Accountancy and Management

August 2017

Malaysian Generation Y‘s Acceptance Level Towards

Cosmetic Surgery

By

Kee Cia Hee

This research project is supervised by:

Ms Yeong Wai Mun

Lecturer

Department of International Business

Faculty of Accountancy and Management

iii

Copyright @ 2017

ALL RIGHTS RESERVED. No part of this paper may be reproduced, stored in a

retrieval system, or transmitted in any form or by any means, graphic, electronic,

mechanical, photocopying, recording, scanning, or otherwise, without the prior

consent of the authors.

iv

DECLARATION

I hereby declare that:

(1) This Research Project is the end result of my own work and that due

acknowledgement has been given in the references to all sources of information be

they printed, electronic, or personal.

(2) No portion of this research project has been submitted in support of any application

for any other degree or qualification of this or any other university, or other

institutes of learning.

(3) The word count of this research report is 11,513 .

Name of Student : Kee Cia Hee

Student ID : 16UKM6145

Signature :

Date : 30 August 2017

v

ACKNOWLEDGEMENTS

I would like to take this opportunity to thank a number of people that have been

helping me on this journey and in completing this research project.

Firstly, I would like to express sincere gratitude to my wonderful supervisor, Ms

Yeong Wai Mun, for sparing her time in providing me with advice and support from

the very start to the end. Without her guidance and encouragement, I would not have

been able to complete this research project.

Also, I want to thank my family for their overwhelming love, support, and

encouragement throughout this course. Additionally, I must thank all the respondents

and friends who devoted their time in taking part in this research project. It would not

have been completed without you. Last but not least I would like to thank the staff of

Institute of Postgraduate Studies and Research.

vi

DEDICATION

This dissertation is specially dedicated to:

Ms Yeong Wai Mun

and

My family, friends, and loved ones

Thanks for the continuous guidance, assistance, and support throughout the journey

of this research project

vii

TABLE OF CONTENTS

Page

Copyright Page............................................................................................................. iii

Declaration ................................................................................................................... iv

Acknowledgements ....................................................................................................... v

Dedication .................................................................................................................... vi

Table of Contents ........................................................................................................ vii

List of Tables ................................................................................................................ x

List of Figures ............................................................................................................. xii

List of Appendices ..................................................................................................... xiii

Preface........................................................................................................................ xiv

Abstract ....................................................................................................................... xv

CHAPTER 1 INTRODUCTION ................................................................................ 1

1.0 Introduction .......................................................................................... 1

1.1 Background of Study ............................................................................ 1

1.2 Problem Statement ............................................................................... 3

1.3 Research Questions .............................................................................. 4

1.4 Research Objectives ............................................................................. 5

1.5 Scope of Study ...................................................................................... 6

1.6 Significance of the Study ..................................................................... 6

CHAPTER 2 LITERATURE REVIEW ..................................................................... 7

2.0 Introduction .......................................................................................... 7

viii

2.1 Review of Literature ............................................................................. 7

2.1.1 Acceptance of Cosmetic Surgery ............................................... 7

2.1.2 Self-Esteem .............................................................................. 11

2.1.3 Conformity ............................................................................... 12

2.1.4 Self-Accessed Attractiveness ................................................... 13

2.1.5 Gender Influencing Acceptance Level .................................... 14

2.2 Hypotheses ......................................................................................... 15

2.3 Theoretical Framework ...................................................................... 16

CHAPTER 3 RESEARCH METHODOLOGY ....................................................... 17

3.0 Introduction ........................................................................................ 17

3.1 Research Paradigm ............................................................................. 17

3.2 Research Design & Approach ............................................................ 18

3.3 Sampling Method ............................................................................... 18

3.3.1 Respondents‘ Profile ................................................................ 19

3.4 Construct Measurement ...................................................................... 19

3.4.1 Acceptance of Cosmetic Surgery Scale (ACSS) ..................... 20

3.4.2 The State Self-Esteem .............................................................. 20

3.4.3 Conformity ............................................................................... 21

3.4.4 Self-Accessed Attractiveness (SAA) ....................................... 21

3.5 Research Instrument ........................................................................... 22

3.6 Data Analyses ..................................................................................... 24

CHAPTER 4 RESEARCH RESULTS ..................................................................... 26

4.0 Introduction ........................................................................................ 26

4.1 Response Rate .................................................................................... 26

4.2 Descriptive Analysis ........................................................................... 27

ix

4.3 Reliability Test ................................................................................... 30

4.4 Normality Test .................................................................................... 31

4.5 Coefficient Correlation ....................................................................... 32

4.6 Multiple Linear Regression ................................................................ 33

4.7 Linear Regression ............................................................................... 35

4.8 Moderation ......................................................................................... 38

4.9 Results from Hypotheses Testing ....................................................... 41

CHAPTER 5 DISCUSSION AND CONCLUSION ................................................ 43

5.0 Introduction ........................................................................................ 43

5.1 Discussion on Findings ...................................................................... 43

5.1.1 Findings on the Hypotheses ..................................................... 45

5.1.2 Moderating Effect of Gender Towards Acceptance Level and

Conformity .......................................................................................... 50

5.2 Implications on the Study ................................................................... 50

5.3 Limitations of the Study ..................................................................... 51

5.4 Recommendations for Future Research ............................................. 52

5.5 Conclusion .......................................................................................... 53

References ................................................................................................................... 54

Appendices .................................................................................................................. 60

x

LIST OF TABLES

Page

Table 3.1: Questionnaire Design 22

Table 3.2: Types of Test 24

Table 4.1: Rate of Return of Questionnaires 26

Table 4.2: Statistics 27

Table 4.3: Gender 28

Table 4.4: Monthly Allowance 28

Table 4.5: Race 29

Table 4.6: Reliability Test 30

Table 4.7: Reliability Statistics I 30

Table 4.8: Reliability Statistics II 30

Table 4.9: Normality Test 31

Table 4.10: Coefficient Correlation 32

Table 4.11: Model Summary 33

Table 4.12: Coefficientsa 33

Table 4.13: ANOVA I 34

Table 4.14: ANOVA II 35

Table 4.15: Model Summary of MLR Test 36

Table 4.16: Collinearity Statistics 36

xi

Table 4.17: Coefficient 37

Table 4.18: Moderation Effect 39

Table 4.19: Moderation Effect Slope Conformity Acceptance Level by

Gender

40

Table 5.1: Hypotheses and Results 43

xii

LIST OF FIGURES

Page

Figure 2.1: Maslow‘s Hierarchy of Need Model 9

Figure 2.2: Theoretical Framework 16

Figure 4.1: Mod Graph 40

Figure 4.2: New Theoretical Framework 41

xiii

LIST OF APPENDICES

Page

Appendix A: Questionnaire 63

xiv

PREFACE

This study is conducted as part of the course requirements for the Master of Business

Administration (Corporate Governance) programme in Universiti Tunku Abdul

Rahman (UTAR). The objective of this research being conducted is to understand the

acceptance level of Malaysian Generation Y (Gen Y) towards cosmetic surgery. As a

matter of fact, the main concentration of this study is to identify how every factor

affects the degree of acceptance level towards cosmetic surgery among Malaysian

Gen Y.

xv

ABSTRACT

Cosmetics procedures have become very common among Malaysians with the

increasing number of Malaysians paying for cosmetic surgery to enhance their

features, be more attractive or to improve their body shape. Cosmetic surgery is

concerned with the maintenance, restoration or enhancement of one‘s physical

appearance through surgical and medical techniques.

This research paper employs questionnaire as the research instrument to achieve the

general research objective. In the questionnaire, the acceptance level of Malaysian

Generation Y (Gen Y) towards cosmetic surgery will be explored. The sample

consists of 260 Malaysian Gen Y. Eventually, statistical results of the study are

reported based on the analyses conducted.

Throughout the study, the findings have clearly revealed that the acceptance level of

Malaysian Gen Y towards cosmetic surgery will be influenced by conformity as well

as gender. However, self-esteem and self-access attractiveness was found

insignificant in influencing the acceptance level towards cosmetic surgery.

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CHAPTER 1

INTRODUCTION

1.0 Introduction

This chapter will be discussed by a few parts. Firstly, the research background and its

problem statement will be discussed. Next, the overview of the research such as

research objectives, research questions and research hypotheses will be listed as

guidance of this research. Significance of study and scope of study will be further

explained in the last part of this chapter which the gap of researches identified and

target respondents will be mentioned.

1.1 Background of Study

Cosmetics procedures have become very common among Malaysians with the

increasing number of Malaysians paying for cosmetic surgery to enhance their

features, be more attractive or to improve their body shape (Yuen, 2015). Cosmetic

surgery is concerned with the maintenance, restoration or enhancement of one‘s

physical appearance through surgical and medical techniques (Swami V. P., 2009).

Dr. Hew Yin Keat who is the president of Malaysia Society of Aesthetic Medicine

(MSAM) said many aesthetic clinics were being set up not only in the Klang Valley

but also in many major cities in Malaysia such as Penang, Johor Bahru, Malacca,

Sabah and Sarawak (Hew, 2015). In fact, cosmetic surgery is increasingly popular

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globally. The preliminary survey done by The American Society for Aesthetic found

from its procedural statically data for the 2015 calendar year suggest that cosmetic

procedures are on the rise (ASAPS, 2016). Plastic Surgery‘s (ASAPS‘) found the idea

of having the beauty ideals popularised by dominant groups has caused an increased

in consumers carrying out cosmetic surgery. Cosmetic surgery is now globalised and

has become normalized.

Based on the past researches, researches are mainly focused on western countries,

which all the results are based on western samples which different results may be get

from the non-western samples. Alexandra Kanters (2015) commented in his research

that cosmetic surgery has become one of the the most extreme ways for one to

improve appearance or body, the rate of undergoing cosmetic surgery has risen

sharply and it is important for researchers to understand the consumer behaviours and

attitude towards this new opportunity. Besides that, the current trend has shown that

the decision making of an individual will be affected by the television program,

particularly programs geared towards elective cosmetic surgery (Alexandra Kanters,

2015).

According to researches did on non-western samples, it is reported that the body

appreciation scale has in the population does not change. Studies stated that the body

appreciation scale of female population in Malaysia can be conceptualized to be

influenced by two factors, which are the general body appreciation and body image

investment (Swami V. &.-P., 2008). General body appreciation consists of eight items

which is used to measure the self-esteem and self image scale whereas body image

investment is a study to understand the willingness of one to spend to improve body

image (Swami C. B., 2011).

In line with all the social factors and market developments, a huge amount of research

has been emerging into the market in order to understand the attitude and behaviour

of consumers in the market. In short, researchers and marketers are wishing to

understand the factors, influence and acceptance of consumers towards cosmetic

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surgery, as this precious information will be a strong base for business to continue

surviving in the market. For instance, past researches have been served as evidences

to show that women tend to have a higher acceptance towards cosmetic surgery and

greater likelihood to go for it (Swami V. &.-P., 2008). Generation Y defined as those

born between year 1980 to year 2000 which has constituted 44 percent of the

population in Malaysia (Country Metres, 2017), hence this research will also focus on

determining will gender of Gen Y in Malaysia affect the acceptance towards cosmetic

surgery.

1.2 Problem Statement

A country report has been done by Euromonitor (2016) found that women tend to be

more participating in today‘s workforce with an earning of middle to high incomes,

and several male grooming products were introduced and being considered as large

players in the market. This has indicated that the beauty industry market is booming

in the recent years and consumers are getting more and more aware about their

personal appearance and outlook. Wilson (2015) stated that the beauty industry has

become the most important trends in year 2015 and special consumer research

findings will be required now and in the future due the demographics of current

spenders have changed as new generation are now taking over the market.

Desirability to change and improve one body has increase in the recent years and

analysis clearly shows that the desire to change one‘s body has now getting more and

more common in the market (Karupiah, 2012). ―Higher disposable incomes among

patients, advances in surgical procedures particularly in terms of safety and the lower

cost of treatments have also served to reduce patient anxiety about cosmetic

procedures‖ (Edmonds, 2007). During the past decade, there has been a dramatic

increase in media that coverage and create awareness for cosmetic surgery among the

public (Crockett, 2007). Tait (2007) mentioned that widely available social media has

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now large create public awareness of cosmetic surgery procedures and is encouraging

consumers to undergo such procedures.

As cosmetic surgery is increasingly popular globally, soon the trend will reach

Malaysia and what is the acceptance level of consumers in Malaysia about cosmetic

surgery? (Yuen, 2015) Factors of one decided to go for cosmetic surgery and how

cosmetic surgery patients are socially evaluated is largely unknown. Research

suggests that public‘s exposure to reality makeover shows will affect the attitudes of

an individual towards cosmetic surgery. The popularity of such procedures have been

increased, these implied that cosmetic surgery is associated with little pain and risk.

So, what does Malaysians think about self or others who pursue cosmetic surgery?

This research focuses mainly to determine the attitudes, level of acceptance towards

cosmetic surgery, perception of Malaysians towards cosmetic surgery in the current

society and the likeability of populations in Malaysian to go for cosmetic surgery.

Besides, the research is also trying to look several interesting about cosmetic surgery

in Malaysia such as which gender, races and age range tend to have a higher

desirability to carry out cosmetic surgery in Malaysia.

1.3 Research Questions

In order to achieve the purpose and objectives of this research, the following research

questions will be answered:

1) Is there a significant positive relationship between self-esteem and acceptance

of cosmetic surgery?

2) Is there a significant positive relationship between conformity and acceptance of

cosmetic surgery?

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3) Is there a significant positive relationship between self-accessed attractiveness

and acceptance of cosmetic surgery?

4) Will demographic influence acceptance of cosmetic surgery?

1.4 Research Objectives

The five main objectives that this research attempts to accomplish are as follow:

1) To examine the acceptance level of Generation Y in Malaysia towards cosmetic

surgery.

2) To investigate the relationship between self-esteem and acceptance of cosmetic

surgery.

3) To investigate the relationship between conformity and acceptance of cosmetic

surgery.

4) To investigate the relationship between self-accessed attractiveness and

acceptance of cosmetic surgery.

5) To investigate the influence of gender towards acceptance of cosmetic surgery.

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1.5 Scope of Study

In order to reduce bias in the findings of this research, the amount of respondents to

participate the data collection process will be divided equally by genders. This

research focus mainly on the gender of respondents as gender will affect the

acceptance of cosmetic surgery (Swami V. P., 2009). All the questionnaires will be

given out to students who are currently studying in University and young working

adults as the age range nowadays strongly represent the Generation Y in Malaysia.

Besides that, as Klang Valley has the most population among all the other cities in

Malaysia, the data collection process will be carried out within Klang Valley so that

the target sample can represent the target population more significantly.

1.6 Significance of the Study

Generation Y has been described as an enigma to most marketers, hence there is a

need to study more on them (Dawn B. Valentine, 2013). Several researches have been

done to study the attitudes towards cosmetic surgery, the acceptance level of cosmetic

surgery or the factor that influence to carry out cosmetic surgery in other foreign

countries, and none of the research was carried out within Malaysia to study what is

the acceptance level of population that are currently staying in Malaysia. By carrying

out this research, the beauty industry can then have a better understanding about the

current main consumers in the market, which is the Generation Y. Due to the aging

population. Gen Y is strongly believing to be consumers who have the highest

spending power in the market followed by Generation X (Dawn B. Valentine, 2013).

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CHAPTER 2

LITERATURE REVIEW

2.0 Introduction

This chapter is divided into few main parts. For the first part, the basic paradigm and

research philosophy used as guidance of this research will be discussed. The second

part will discuss about the sample selection criteria for this research.

2.1 Review of Literature

Under this subsection, definition of Gen Y, character of Gen Y, spending behaviour

of Gen Y, and spending pattern of Gen Y will be discussed based on the past research

studies.

2.1.1 Acceptance of Cosmetic Surgery

Cosmetic surgery is understood to be part of the individual's reflexive construction of

self-identity, and leads to a focus on issues such as self-determination, self-esteem,

and the relationship between body and identity (ElhamFakhriTomalieh, 2015).

Acceptance is a choice, which individual made to determine what kind of actions will

be taken and it is acknowledgement of facts of a situation (Kane, 2015). High degree

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of acceptance meaning that individuals have addiction or dependence on a certain

behaviour which is hard to define whether is good or bad. It can be a form of self-

deception. Acceptance of cosmetic surgery can be explained by using the Maslow‘s

Hierarchy of Needs motivational model theory, which include social motivation and

interpersonal motivation and self-actualization (Donna Henderson-King, 2005).

Motivation are used to explain why people do what they do. A motive is what drives

a person to act in a certain way or at least develop a desire for specific behavior.

Maslow (1943) stated that people are motivated to achieve certain needs. When one

need is fulfilled a person seeks to fulfill the next one, and so on. The earliest and most

widespread version of Maslow's hierarchy of needs includes five motivational needs,

often described as hierarchical levels within a pyramid.

Social motivation can be defined as the belongingness of individual to be accept by

work group, family, affection or relationships (Shelly L Gable, 2012). Belongingness

needs can also relate to desires for love, friendship within one‘s given community

(Barnet, 2015). Acceptance of cosmetic surgery underlies on one‘s concern about

their appearance which it serves as a mean to boost own self-esteem and enhance

social or career potential (Bill Thornton, 2013). Figure 2.1 shows the Maslow‘s

hierarchy of needs model which consists of 5 stages. This model was developed by

Abraham Maslow which suggests that ―individual needs exist in a hierarchy

consisting of physiological needs, security needs, belongingness needs, esteem needs

and self-actualization needs‖ (Barnet, 2015). According to the model, physiological

needs include some basic requirements such as food, water and other factor that

required for one to survive; safety needs are the safety need one required in a physical

environment; belongingness needs come as the third stage which stated that

individual need the sense of belonging and love from one another; esteem needs are

those associated with one‘s self respect and others and finally self actualization is the

last stage which mentioned that individual need to feel the achievement of own

potential and capacities (Maslow, 1943). As mentioned by Henderson-King and

Henderson-King (2005) one‘s acceptance level can be measure through

belongingness needs and esteem needs, which this research will focus more on the

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social influence and self reported information to test on the acceptance level of

cosmetic surgery.

Figure 2.1: Maslow‘s Hierarchy of Need Model

How do consumers think about cosmetic surgery? Do consumers feel bad about their

bodies? What kind of attitudes will be given by consumers towards the others who

had cosmetic surgery before? All these questions examine the acceptance of cosmetic

surgery and the outcome will come along with a short narrative about the future

behaviour of consumers towards cosmetic surgery (Fuzzell, 2010). Acceptance of

cosmetic surgery may be correlated with body image (Swami V. P., 2009).

All the explanation above can be further proved by objectification theory which stated

that as with women, men (and boys) may come to internalize these standards and

engage in self-objectification (McKay, 2013). Dawn M. Szymanski (2011) wrote that

Self-Actualization

Personal Growth and Fulfillment

Esteem Needs

Achievement, Status, Responsibility, Reputation

Belongingness and Love Needs

Family, Affection, Relationship, Work Group, etc

Safety Needs

Protection, Security, Order, Law, Limits, Stability, etc

Biological and Physiological Needs

Basic Life Needs – Air, Food, Drink, Shelter, Warmth, Sex, Sleep, etc

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―objectification theory posits that girls and women are typically acculturated to

internalize an observer‘s perspective as a primary view of their physical selves‖. In

another word, objectification theory provides an illumination that female tends to

have higher acceptance towards actions that can lead to better improvement on their

body. Objectifying occurs within actual interpersonal, social encounters, visual media

and lastly culture (Rachel M.Calogero, 2016). Women are gazed at more than men

and they tend to have more conscious about the body appearance more than male.

Secondly, objectification theory proposed that sexually objectifying gaze will

influence female to be more aware of their attractiveness as males are pictured

looking or staring directly on female often. At a psychological level, objectification

theory suggested that individual who adopt a peculiar view of self and perceived

themselves as objects to be looked at and evaluated tends to accept, believe and carry

out actions that they perceived to be right and increase their attractiveness (Dawn M.

Szymanski, 2011). This indicates that the acceptance of cosmetic surgery which is

believe to help consumers to improve appearance may be influenced by the degree of

self-esteem, approval or influence of others and self-accessed attractiveness, which

again formed the theoretical framework as proposed beforehand.

Research was carried out in order to understand the top reasons for consumers to

undergo cosmetic surgery and the outcome was self-esteem, better attractiveness,

appearance improvement and conformity to the others. Research also reported that the

acceptance of cosmetic surgery is completely personal and hardly related to the

external environment as the decision made for cosmetic surgery was socially

constructed (Bill Thornton, 2013). Additional exploratory analysis showed that

education level will influence the acceptance level of cosmetic surgery. Research

done Swami C. B. (2011) reported that acceptance level of cosmetic surgery can be

determined by measuring the personality of consumers, level of consumers‘ self

esteem, degree of conformity, self-accessed attractiveness and demographics such as

gender and education level. By summarizing all the past research, the theoretical

framework of this research was generated as shown in Figure 2.2 which the

dependent variable, Acceptance level of cosmetic surgery is believed to be influenced

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by three independent variables such as Self-Esteem, Conformity and Self-Accessed

Attractiveness and Gender will be used as a moderator for this research.

2.1.2 Self-Esteem

Self esteem refers to aspects of the way we view ourselves, the thoughts we have

about ourselves and the value we place on ourselves as people‖ (Fennell, 2016).

When one felt themselves as a person of worth, the self-esteem value within the one

is high. When one is with positive self-esteem, they tend to be more confident, self-

directed, aware of personal strengths, optimistic, good self-care and have high trust

towards self (Rosenberg M. , 1965). When one felt themselves as a person of worth,

the self-esteem value within the one is high. High self-esteem individuals tend to be

more positive and believe that they have the ability to take charge of own life without

any aid or changes in their life, which tend believe to have a lower acceptance level

towards cosmetic surgery (Viren Swami J. L., 2012).

For individuals who are low self-esteem, they tend to feel unworthy, incapable, and in

fact feel poorly within self and often feel like there is a need to improve self by

enhancing own appearance or figure. Low self-esteem may cause one to have feelings

of mistrust people, fear of taking risks, perfectionist attitude towards people and self

and fear of being ridiculed (Tam, 2012). One with lower self-esteem will more likely

to accept cosmetic surgery as they are eager and aggressive in enhancing and

improving own self. Besides, Tam (2012) also reported that individuals who have

lower self-esteem tends to have stronger concern about their appearance which then

led to higher acceptance of cosmetic surgery. Self-esteem is the general feelings of

one have for themselves.

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2.1.3 Conformity

As ―conformity is the degree of an individual‘s behaviours, attitudes or belief that

will be adjusted to meet another group or someone else‘s expectation‖ (Makan Amini,

2010), conformity can also be indicates as an agreement to the majority. Conformity

can occur as social pressure to one. Social pressure is a measure that examine the

tendency of one to compare self with the group, the images showed by the media, the

perception of the peers and families or even the look of models and actors (Swami V.

P., 2009). There are several types of conformity, for example Mann (1987) identified

that there are three types of conformity which are Normative, Informational and

Ingratiation. For this research, the degree of conformity will be mainly focus on the

ingratiation conformity which is influential of peers, family members and partners

influence. H2 shows the hypothesis proposed for this independent variable and the

dependent variable.

1) Normative Conformity

It comes in as a form of group pressure where individual feel like fitting themselves

in as a group with the others. However, marketer may have to be careful as this form

of conformity may involves compliance which some individual accepts the view of

the group publicly while rejecting it privately (McLeod S. , 2007).

2) Informational Conformity

Informational conformity occurs when individual is lack of knowledge and

information and seeking for guidance and help from the group. This type of

conformity often involves an individual accepts the views of groups and adopt them

individually, hence group influence only comes in the first few stage and self decision

making comes later.

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3) Ingratiation Conformity

This occurs when an individual trying to gain acceptance from other people such as

friends, families or partners. Unlike normative influence, ingratiation conformity

comes in when group pressure is just part of the decision to conform and individual is

seeking the need for social rewards.

For this research, the degree of conformity will be mainly focus on the influential of

peers, family members and partners influence. H2 shows the hypothesis proposed for

this independent variable and the dependent variable.

2.1.4 Self-Accessed Attractiveness

Self-accessed attractiveness in this research refers to the degree to how an individual

rate themselves as pleasing or attractive based on the physical appearance, body size,

height, weight and figure (Teresa Rzepa, 2014). The term physical appearance

somehow being implied as sexual attractiveness or desirability of one. It can be

evaluated by both gender, in other word, both male and female can evaluate their own

physical traits in order to determine whether or not they are attractive for themselves

and the others (S.Koziel, 2013). Research found that normally attractiveness is more

commonly be found in new relationships, which individual tends to have higher

conscious about their own and be more aware about their attractiveness for the new

partner. This implies that when individuals are in a relationship, they tend to take care

of their appearance and physical attractiveness more, which tend may lead to higher

likeability towards cosmetic surgery, and higher acceptance of cosmetic surgery.

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2.1.5 Gender Influencing Acceptance Level

Adrian Furnham (2014) mentioned that females are expected to go for cosmetic

surgery in British than males given that the majority of cosmetic surgery patients are

women. Women will undertake cosmetic treatment in order to obtain bodies that meet

the ideal feminist look regardless of the cosmetic surgery, which is often painful and

risky, and each operation involves its own potential complication. These women

appear to be very obsessed with their physical appearance (ElhamFakhriTomalieh,

2015). The increase of cosmetic surgery is a result of fighting signs of aging. It is an

attempt to reproduce the body‘s youth and to make general corrections of what is

perceived as bodily problems, even among very young consumers which has made

cosmetic surgery one of the fastest growing industries (Haiken, 2015).

Aimini Makan (2010) also reported that due to different sex may have different

practical implications on the information and norm influences, sex differences are

particularly a moderator towards conformity. Fuzzell (2010) mentioned that women

tend to have a lower body image than men which then have a higher acceptance

towards cosmetic surgery and hence gender will definitely have an effect on

acceptance of cosmetic surgery. The immediate past president of MSAM, Dr. Chin

Shih Choon also commented that there were more female than male clients (Chin,

2015), hence there is a need for this research to take gender as a moderator towards

the relationship between conformity and acceptance level.

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2.2 Hypotheses

Hypotheses are statements which illustrate the predicted relationship between events

and variables, and the hypotheses of this research will be as follow:

H1: Self-esteem will have a direct positive effect on the acceptance level towards

cosmetic surgery.

H2: Conformity will have a direct positive effect on acceptance level towards

cosmetic surgery.

H3: Self-accessed attractiveness will have a direct positive effect on the acceptance

level towards cosmetic surgery.

H4: Gender will affect the relationship between conformity and acceptance level

towards cosmetic surgery.

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2.3 Theoretical Framework

Figure 2.2: Theoretical Framework

Source: Developed for the research.

Self-Esteem

Conformity

Self-Accessed

Attractiveness

Acceptance Level

Towards Cosmetic

Surgery

Gender

H2

H1

H3

H4

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CHAPTER 3

RESEARCH METHODOLOGY

3.0 Introduction

This chapter is divided into few main parts. For the first part, the basic paradigm and

research philosophy used as guidance of this research will be discussed. The second

part will discuss about the sample selection criteria for this research. Methods used to

carry out to collect data for this research will be discussed in part three and lists of

analysis tests for this research will be determined in part four.

3.1 Research Paradigm

This study applies the positivism paradigm to guide the research design. For

positivists, knowledge about the social world can be obtained objectively, what we

see and hear is straightforwardly perceived and recordable without too many problem

(Edirisingha, 2012). All the information and data required for this research can be

observed, measured and studied scientifically. Variables can be isolated, measured

the ways they varied, look at the relationships between variables, develop hypotheses

about these relationships and draw conclusions on the basis of these studies.

(Creswell, 2014) stressed out that a positivism research was started with a theory,

which this research will be aided by the Objectification Theory and Motivation

Theory.

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3.2 Research Design & Approach

The theoretical perspective most often associated with quantitative researchers is

phenomenology (Gray, 2013). As for this research, only quantitative methods will be

used. A descriptive study primarily focused on determining the ―cause-effect‖

relationship between variables. It is used to obtain information with methods that

trying to describe what is existing with respect to the situational variables. Based on

(Williams, 2011),developing different techniques in a quantitative research able to

produce data in the form of numbers, for example, a quantitative research method

provides precise, quantitative, and numerical data. In this research, questionnaires

were given out to collect analytical data and several tests will be carried out to

provide more interesting information. Questionnaires will be given to working adults

and university students whom aged between eighteen to thirty-seven.

3.3 Sampling Method

This research is using non-probability sampling method. Quota sampling is useful for

data collection without a probability sample as it will create a sample that is as

representative as possible for the target population being studied (Creswell, 2014).

―The quota sample improves the representation of particular strata (groups) within the

population, as well as ensuring that these strata are not over-represented‖ (Mettle L.

Baran, 2016). Rada and Martin (Vidal Diaz de Rada, 2014) mentioned that quota

sampling is the best method to collect data for better representation of categorical

variable attainment distribution. Quota samplings is a cheap and convenient method

to generate a sample when a probability sample is not available for data collection

process (Mettle L. Baran, 2016). Quota sampling can well control respondents in a

selected cluster in order to define the ultimate survey units. The research can have a

higher degree of representative when it has a well controlled samples (Jae W. Song,

2011). Quota sampling method give a better way to represent a population more

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realistically and it can obtain results close to conventional probability sampling

(Gergely Szolnoki, 2013).

As gender will be focus for the forth hypothesis and test for moderation effect

towards relationship, quota sampling increases the reliability of the test and reduce

maximum bias (Creswell, 2014).

3.3.1 Respondents’ Profile

Two hundred and sixty questionnaires were given out to undergraduates who

currently stays in Malaysia for the data collection process. All the respondents are

equally divided into 50% male and 50% female, age ranging between eighteen to

thirty-seven years old. These participants are selected carefully in order to make sure

there will be minimum biases for the data collected. In order to reduce the biasness of

this research, all respondents will be asked several screening questions before they

were given the questionnaire to answer. Questions such as ―Are you currently staying

in Malaysia for long term?‖ and ―Are you aged between eighteen to thirty-seven?‖

the answer from respondents will need to be ―yes‖ and the age will need to fall into

the age within target sample in order for the questionnaires being take into account.

3.4 Construct Measurement

Majority of the items in the questionnaire used 7 point Likert scales. ―7-point Likert

scale is more likely to reflect a respondent‘s true subjective evaluation of a usability

questionnaire item than a 5-point item scale‖ (Finstad, 2017).

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3.4.1 Acceptance of Cosmetic Surgery Scale (ACSS)

The acceptance of cosmetic surgery scale was found in Henderson-King &

Henderson-King (2005) which is a method specifically designed to measure the

elements towards consumers‘ attitude of cosmetic surgery. For the purpose of the

current study, the ACSS consists of nine statements to which respondents indicates

their level of agreement. Response options are ranged from 1 (strongly disagree) to 7

(strongly agree).

Respondents were required to answer questions such as ―Cosmetic surgery is a good

thing because it can help people feel better about themselves.‖, ―In the future, I could

end up having some kind of cosmetic surgery.‖, ―If it would benefit my career I

would think about having cosmetic surgery.‖ and ―I have sometimes thought about

having cosmetic surgery.‖ To examine respondents‘ acceptance level of cosmetic

surgery. The higher the mean, the higher the acceptance level of cosmetic surgery.

3.4.2 The State Self-Esteem

The State Self-Esteem Scale is a modified scale comprised of 20 items from Pliner et.

al (1990) and Fleming & Courtney (1984) modified Janis-Field scales (Heatherton,

1991). However, only six items were used for the questionnaires in this research after

factor analysis. SSE Scale assesses self-esteem in five elements: academic,

performance, social, appearance, and general self-esteem. Each item in scored on a 7-

point Likert scale with response options ranging from Strongly Disagree (1) to

Strongly Agree (5).

Respondents are enquired questions such as ―I take a positive attitude towards

myself‖, ―I am able to do things as well as most other people do‖ and ―I feel that I

have a number of good qualities‖ in order to understand further about the self-esteem

level of the target sample.

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3.4.3 Conformity

To access participants‘ conformity to the others, respondents are required to complete

six statement using the Martin-Larsen Approval Motivation Scale (Martin, 1984).

MLAM-sf was created to measure the desirability of respondent towards receiving

evaluations and approval from the society, friends and families. It contains some

counter-balanced statements to which required respondents to answer based on 7-

point Likert scale ranging from Strongly Disagree (1) to Strongly Agree (1) in order

to further express their inner thoughts. Higher scores reflect a higher need for

acceptance or social approval.

In order to examine the degree of conformity, respondents were given questions such

as ―I often rely on, and act upon, the advice of others.‖, ―I change my opinion in order

to please someone else.‖, ―In order to get along and be liked, I tend to be what people

expect me to be.‖ And ―It is important to me that I behave ―properly‖ in social

situations.‖

3.4.4 Self-Accessed Attractiveness (SAA)

Respondents are required to provide self-estimates of their overall physical

attractiveness, overall facial attractiveness, overall attractiveness of body weight and

higher, and overall perceived self-attractiveness. The questions included in the

questionnaire are modified and the original scale consists of twenty questions which

required respondents to grade various body parts using a normal distribution curve. It

was modified to become six simpler statements in order to make sure that respondents

will not get too confused in answering the questionnaire (Swami et al., 2009).

All the respondents were required to grade themselves by strongly disagree or

strongly agree about statements such as ―I think my overall physical attractiveness is

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high‖, ―I think myself overall facial is attractive‖, ―For me, my body weight and size

are attractive‖ and ―I find my overall body weight and size is attractive.‖

3.5 Research Instrument

Several scales were adapted from past researches in order to build the questionnaire

for this research.

Table 3.1: Questionnaire Design

Items

Adopted from

Part A

Acceptance of

Cosmetic

Surgery Scale

(Swami, V.,

Premuzic, T.

C., Bridges, S.,

and Furnham,

A., 2009)

1. It makes sense to have minor cosmetic surgery rather than

spending years feeling bad about the way you look.

2. Cosmetic surgery is a good thing because it can help people feel

better about themselves.

3. In the future, I could end up having some kind of cosmetic

surgery.

4. People who are very unhappy with their physical appearance

should consider cosmetic surgery as one option.

5. I have sometimes thought about having cosmetic surgery.

6.I would seriously consider having cosmetic surgery if my partner

thought it was a good idea.

7. If it would benefit my career I would think about having plastic

surgery.

8.I would seriously consider having cosmetic surgery if I thought

my partner would find me more attractive.

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9. If a simple cosmetic surgery procedure would make me more

attractive to others, I would think about trying it.

Part B

Self Esteem

Scale

(Resenberg, M.,

1965)

10. On the whole, I am satisfied with myself.

11. At times, I think I am no good at all.

12. I feel that I have a number of good qualities.

13. I am able to do things as well as most other people do.

14. I feel I do not have much to be proud of.

15. I take a positive attitude towards myself.

Part C

Conformity

Scale

(Swami, V.,

Premuzic, T.

C., Bridges, S.,

and Furnham,

A., 2009)

16. I often rely on, and act upon the advice of others.

17. I would rather be myself than be well thought of.

18. I change my opinion (or the way that I do things) in order to

please someone else.

19. In order to get along and be liked, I tend to be what people

expect me to be.

20. It is important for me that I behave ―properly‖ in social

situations

21. If there is any criticism or anyone says anything about me, I can

take it.

22. I am careful at parties and social gatherings for fear that I will

do or say things that others won‘t like.

Part D

The Estimating

Physical

Attractiveness

Scale

23. I think my overall physical attractiveness is high.

24. I find myself overall facial is attractive.

25. For me, my body weight and size are attractive.

26. I find my overall body shape and figure is attractive.

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27. I am satisfied with my current height. (Talbot, T. L.,

Lenzo, C. B.,

2012)

28. I will grade myself as an attractive person.


3.6 Data Analyses

For the data analysis process for this research project, Statistical Package for the

Social Science (SPSS) software was used. All the data were key in after data

collection process and several tests were carried out to generate the findings of this

project. For example, Reliability test was carried out to determine the reliability of

this research, Descriptive Frequency Test was carried out to measure the frequency of

certain useful data collected via the questionnaires, multiple linear regression was

used to test the relationship between dependent variable and independent variables

and also moderation effect of gender towards the relationship and lastly, coefficient

correlation test was carried out to determine the pattern of relationship between all

variables.

Table 3.2: Types of Test

Types of Test Purpose

1. Descriptive Frequency - To outline the demographics of respondents

2. Reliability Test - To investigate the reliability of the current

study, cronbach alpha must be >0.7 to be

reliable

3. Normality Test - To ensure all the data are normally

distributed, value of skewness must be at sig.

level of <0.05

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4. Factor Analysis - To retain only useful items for variables,

value of grouped items must be >0.35

5. Multiple Linear Regression - For hypotheses testing and to test for

moderation effect, sig. value must be <0.05

to be significant

A pilot study was a final preparation for data collection, in order to refine the data

collection plan in terms of content and procedure to be followed (Baškarada, 2014).

Pilot test provide researcher with interviewing experience and feedback regarding the

interview guide and improve skills in writing field notes. Fifty pilot tests were carried

out on target participants through online survey. All the data collected from pilot tests

were used to pre-test the validity and reliability of variables that are going to be used

in this research. Respondents were enquired about their understanding of the

questionnaire upon completion and were allowed to provide useful comment or

further improvement about the questionnaire.

Reliability test will be carried on the 50 results collected from respondents and the

results shown must have all variables to have a cronbach alpha of more than 0.6. The

research items are reliable as long as the cronbach alpha is 0.7 or greater. The purpose

of carrying out reliability test before hand is to clean all the data and make sure that

this research is worth and correct to carry out further.

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CHAPTER 4

RESEARCH RESULTS

4.0 Introduction

Within this chapter, it is divided into few main parts. For the first part, the research

background, research problem statement will be discussed. Next, the overview of the

research such as research objectives, research questions and research hypotheses will

be listed as guidance of this research. Significance of study and scope of study will be

further explained in the last part of this chapter which the gap of researches identified

and target respondents will be mentioned.

4.1 Response Rate

Table 4.1: Rate of Return of Questionnaires

Questionnaires Distributed 300

Total Response 260

Total Response Rate (%) 86.7%


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In this study, a total of 300 sets of questionnaires are distributed to the working adults

and postgrads students in Klang Valley, Malaysia. The researcher received 260 sets of

complete questionnaires which indicated a response rate of 86.7%.

4.2 Descriptive Analysis

Descriptive analysis was used to determine frequency and percentage to all the responses

by the respondents. The 260 responses collected were explained in this section.

Table 4.2: Statistics

Gender Nationality

Monthly

Allowance Race

N Valid 260 260 260 260

Missing 0 0 0 0

Mean 1.50 1.15 1.68 1.44

Mode 1a 1 1 1

Std. Deviation .501 .447 .948 .870

Skewness .000 3.003 1.070 1.879

Std. Error of Skewness .151 .151 .151 .151

Percentiles 25 1.00 1.00 1.00 1.00

50 1.50 1.00 1.00 1.00

75 2.00 1.00 2.00 1.00


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Table 4.3: Gender

Frequency Percent Valid Percent Cumulative Percent

Valid Male 130 50.0 50.0 50.0

Female 130 50.0 50.0 100.0

Total 260 100.0 100.0


Table 4.4: Monthly Allowance

Frequency Percent

Valid

Percent

Cumulative

Percent

Valid RM1000 and below 158 60.8 60.8 60.8

RM1001 - RM2000 42 16.2 16.2 76.9

RM2001-RM3000 46 17.7 17.7 94.6

RM3001 AND ABOVE 14 5.4 5.4 100.0

Total 260 100.0 100.0


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Table 4.5: Race

Frequency Percent

Valid

Percent

Cumulative

Percent

Valid CHINESE 196 75.4 75.4 75.4

MALAY 28 10.8 10.8 86.2

INDIAN 21 8.1 8.1 94.2

NON-MALAYSIAN 15 5.8 5.8 100.0

Total 260 100.0 100.0


Table 4.2 to 4.5 shows the demographic profile of all 260 respondents who are all

stay in Malaysia currently. All the questionnaires are equally distributed to 130 male

respondents and 130 female respondents. The income group were categorised to two

groups which are the high income and low income group. 76.2% of the respondents

have monthly allowance of not more than RM2,000 and they are considered as the

low income group which 23.1 % of the respondents were renamed as high income

group as they have income of more than RM20,001.

The dependent variable of acceptance level towards cosmetic surgery has a mean of

3.90 with standard deviation of 1.572. The mean of independents variables, Self-

Esteem is 5.14 with a standard deviation of 1.026, Conformity 4.50 with standard

deviation of 1.115 and Self-Accessed Attractiveness has a mean of 4.44 with standard

deviation of 1.211.

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4.3 Reliability Test

Table 4.6: Reliability Test

Cronbach's Alpha Cronbach's Alpha Based on Standardized Items N of Items

.820 .823 3


Table 4.7: Reliability Statistics I


.703 .712 7


Table 4.8: Reliability Statistics II


.925 .926 5


Reliability test were carried out again to measure the reliability of variables after

collecting all the data from 260 respondents. The results showed that Cronbach‘s

alpha obtained from the second tests are higher than the first reliability test, and hence

result from second analysis is used. The dependent variable scored 0.952 without any

items to be deleted, and Self-Esteem scored 0.820 with 3 items deleted, Conformity

scored 0.703 without any items to be deleted and Self-Accessed Attractiveness scored

0.925 with 1 item deleted. This research will proceed based on the results from

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second test as the Cronbach‘s alpha of all variables are higher and items to be deleted

are lesser.

4.4 Normality Test

A normality test has been carried out to make sure that all the data were distributed

normally that it is suitable to generate statistical results for this research (Cash, Duel

& Perkins, 2002). Skewness and the Kurtosis variable are used to evaluate the

normality of the data.

Table 4.9: Normality Test

Variable Mean Std.

Deviation

Skewness Kurtosis

Statistic Std.

Error Statistic

Std.

Error

Acceptance

Level 3.90 0.098 -0.037 0.151 -1.012 0.301

Self-Esteem 5.16 0.060 -0.587 0.151 0.323 0.301

Conformity 4.53 0.069 -0.148 0.151 -0.239 0.301

Self-Accessed

Attractiveness 4.44 0.075 -0.321 0.151 0.096 0.301


As shown in Table 4.9, the values obtained from the normality test by all variables

are ranged between -0.587 and 0.323. Normality test evaluate the data collection

process which if the kurtosis index is below 10 and the skewness index is less than 3,

the data collected is normally distributed (Myers et al., 2003). The results show that

the data collected for this research were normally distributed and collected, and hence

this research is a valid research.

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4.5 Coefficient Correlation

Coefficient correlation test has been conducted to measure the correlation

relationships between all dependent and independent variables. Table 4.7 shows the

value for Pearson Correlation and significant value.

Table 4.10: Coefficient Correlation

Correlations

DV IV1 IV2 IV3

1 .179**

.446**

.219**

.004 .000 .000

260 260 260 260

.179**

1 .375**

.492**

.004 .000 .000

260 260 260 260

.446**

.375**

1 .308**

.000 .000 .000

260 260 260 260

.219**

.492**

.308**

1

.000 .000 .000

260 260 260 260

**. Correlation is significant at the 0.01 level (2-tailed).


Table shows the value for Pearson Correlation and significant value. Result showed

that the relationship has scored a beta of 0.446 with significant value of 0.000,

indicating that conformity has a positive relationship towards acceptance level with a

significant value of 0.000.

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4.6 Multiple Linear Regression

Table 4.11: Model Summary

Model R

R

Square

Adjusted

R Square

Std.

Error of

the

Estimate

Change Statistics

Durbin-

Watson

R Square

Change

F

Change df1 df2

Sig. F

Change

1 .455a .207 .198 1.40825 .207 22.287 3 256 .000 1.440


Table 4.12: Coefficientsa

Model

Unstandardized

Coefficients

Standardized

Coefficients

t Sig.

95.0% Confidence

Interval for B

B

Std.

Error Beta

Lower

Bound

Upper

Bound

1 (Constant) .845 .500 1.691 .092 -.139 1.830

IV1 -.048 .102 -.031 -.471 .638 -.248 .152

IV2 .601 .086 .426 7.016 .000 .432 .770

IV3 .134 .084 .103 1.594 .112 -.032 .299


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Table 4.13: ANOVA I

Model Sum of Squares df Mean Square F Sig.

1 Regression 132.600 3 44.200 22.287 .000b

Residual 507.694 256 1.983

Total 640.294 259

*** Significant value <0.01 **Significant value <0.05 *Significant value <0.1


Table shows the value of R-Square generated from the multiple linear regression tests.

When there is no relationship between independent and dependent variables, the r-

square will be 0 and if there is a perfect relationship between dependent and

independent variables, then the r-square will be 1. The result shows that the r-square

value is 0.207 which indicates that all the independent variables used in this research

explain 20.7% of the variability of the dependent variable. The result of F-test shows

in table determines that the model is a good fit for the data by having a p-value of

0.000 which is less than 0.05.

Table shows the coefficient between independent variable and dependent variable to

see relationship between. The significant value for the first variable, Self Esteem is

more than 0.01 with a beta of -0.048, meaning that hypothesis null is not rejected.

Conformity is the second variable and it has a beta of 0.601 with significant value of

0.000, which is lower than 0.01, hence hypothesis null 2 is rejected. Hypothesis null

for the third variable, Self-Accessed Attractiveness is not rejected as it has beta of

0.103 with significant level more than 0.01.

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From the result generated, it enables us to make an equation for the regression line

which is:

This equation explains that:

- Conformity will influence the acceptance level towards cosmetic surgery by 0.601

ph constantly.

4.7 Linear Regression

Table 4.14: ANOVA II

Model Sum of squares df Mean

square F

1

Regression 132.600 3 44.2 22.287**

Residual 507.694 256 1.983

Total 640.294 259

*significant at the 0.1 level, ** significant at the 0.01 level


The result of F-test shows in table 4.14 determines that the model is a good fit for the

data by having a p-value of 0.000 which is less than 0.05. The F-value is determined

to measure the potential that there will be at least one relationship appear by

conducting the linear regression analysis (Aaker et al., 2003). The F value for this

research is recorded at 22.287 and the p-value indicates that it is significant, thus the

null hypothesis is rejected.

Y = a + b1 *X1 + b2 * X2 + … + bp*Xp

Y = 0.0845 + 0.601 (Conformity)

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Table 4.15: Model Summary of MLR Test


The model summary showed in table 4.15 is obtained from linear regression test to

assess the variance explained by the construct within the study. R-Square, also

known as the Coefficient of determination is a commonly used statistic to evaluate

model fit. R-square is 1 minus the ratio of residual variability. When the variability

of the residual values around the regression line (Field, 2009). The result from the

test showed that a total of 20.7% of the variance of the outcome has been explained

by the model adopted by this study. The lower the R2 indicated that there are more

factors may be relevant towards the outcome of the independent variable of this

study are not included. Durbin-Watson with value of 1.440 showed that there is

absence of autocorrelation from the regression analysis (Montgomery, Peck and

Vining, 2001), in another word there is no relationship between values separated

from each variables and no pattern shown in error of this research.

Table 4.16: Collinearity Statistics

Variables Collinearity Statistics

Tolerance VIF

Self Esteem 0.703 1.423

Conformity 0.842 1.191

Self-accessed attractiveness 0.740 1.351


Model R R2 Adjusted

R-Square

Std. Error Durbin-

Watson

1 0.455 0.207 0.198 1.4082 1.440

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The variation inflation factor (VIF) of each variable suggest that there are association

recorded between variables which proposed the potential existence of

multicollinearity in this study (Craven & Nash, 2009). As proposed by Bowerman &

O‘Connell (1990), the acceptable threshold in defining the absent of multicollinearity

is proposed with the tolerance values of more than 0.1 and the VIF value of less than

10. As shown in the table that all variables have fulfilled the requirement proposed,

hence the current study hereby present a zero multicollinearity within the model and

the tolerance level is acceptable.

Table 4.17: Coefficient

Hypothesis

Unstandardized

Coefficients

Standardized

Coefficients t-

statistic

Sig.

(p-

value)

Decision

Beta Std.

Error

Beta

(Constant) 0.845 0.500

SE -> AL -0.048 0.102 -0.031

-0.471 0.638 Not

Supported

C -> AL 0.601 0.086 0.426 7.016** 0.000 Supported

SAA ->

AL 0.134 0.084

0.103 1.594 0.112

Not

Supported

Notes: SE = self esteem; AL = Acceptance level; C = Conformity; SAA = Self-

accessed attractiveness



Table 4.17 shows the coefficient between independent variable and dependent

variable to see relationship in between. All the independent variables were tested

individually on the dependent variable to understand the relationship in between. This

method was carried out in order to make sure that there is no overlapping in the data

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which will affect the p-value that identify the significant level of each relationship

(Leech, Barret & Morgan, 2005).

According to the result obtained, the first proposed hypothesis which is the causal

relationship between acceptance level of cosmetic surgery and self-esteem is not

significant. The relationship between self-esteem and acceptance of cosmetic surgery

has scored a beta of -0.048 and t-stats of -0.471 with a p-value of 0.638 which is

higher than 0.05. Hence, the decision of not supporting H1 is made.

H2 which proposed that conformity will influence the acceptance level of cosmetic

surgery has a beta value of 0.601 and t-stats value of 7.016 with a p-value of less than

0.01. This indicates that the relationship between acceptance level and conformity is

significant and supported at 95% confidence interval of the construct. In another word,

H2 is supported.

Self-accessed attractiveness is the third variable which proposed that there is a

relationship between acceptance level of cosmetic surgery and self-accessed

attractiveness is not supported as well due to the p-value scored for the relationship is

more than 0.01. H3 has a beta of 0.134 and t-stats of 1.594, but the p-value scored in

this test is 0.103, which is higher than 0.01. Hence the decision of not supporting H3

is made for this research.

4.8 Moderation

In order to test whether or not gender will moderate the relationship between

conformity and acceptance level, the moderation test was carried out by using

multiple linear regression analysis. The technique and steps used to investigate the

moderation relationship were showed below.

Step 1: Recode categorical variable > Dummy Variable

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Step 2: Centered both dependent and independent variable > Centered Variable

Step 3: MLR test on dependent, independent and categorical variable

Table 4.18: Moderation Effect

Model R R Square Std. Error t-stats

1 0.463 0.215 1.399 2.259**

2 0.974 0.949 0.356 60.948**



Moderation effect occurs when R-Square of one model increase in another interaction

relationship (Dujin, 2011). Table 4.18 showed the results obtained through multiple

linear regression and r square scored in model 1 did increase in model 2, indicating

that moderation effect does exist on the relationship between acceptance level and

conformity. R Square for model 1 increase from 0.215 to 0.949 in model 2, it stated

that there is potentially significant moderation between these two variables. The p-

value for both model in this test are 0.000 which is less than 0.01 indicates that this

relationship is significant. ModGraph was used in order to further understand how

gender moderate the relationship.

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Figure 4.1: Mod Graph


Figure 4.1 showed the ModGraph generated by inserting the beta and mean of each

variables. The graph showed that both gender tend to have a higher acceptance level

when conformity goes higher, which male has a higher influence compared to female.

Table 4.19: Moderation Effect Slope Conformity Acceptance Level by Gender


Table 4.19 showed the value scored by the slope shown in ModGraph which

representing the acceptance level for each gender in different conformity stages.

Low Med High

Male 0.25448 0.29 0.32552

Female 0.19931 0.2315 0.26369

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Conformity was divided into three categories, low, medium and high and value were

plotted to show the relationship. As we can see, the value of slope for both gender

increase when conformity increase, which again proved the relationship between

acceptance level and conformity. Moderation effect occurs when male tends to have a

higher acceptance level compared to female at the same level of conformity. The

acceptance level of female towards cosmetic surgery is just 0.19931 when conformity

is low while male has a score of 0.25448.

4.9 Results from Hypotheses Testing

Figure 4.2: New Theoretical Framework

Notes: Direct relationship Moderation effect



Figure 4.2 showed the new theoretical framework generated after conducting all the

analysis to validate the causal relationships between all the predictor variables and

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acceptance level of cosmetic surgery of Gen Y in Malaysia. The findings suggest that

all the proposed relationship are significant and self-esteem, conformity and self-

accessed attractiveness do have direct relationship towards acceptance level of

cosmetic surgery. As seen, H1, H2 and H3 are supported with a significant value of

0.000. Besides, the proposed moderation effect of gender will influence the

relationship between conformity and acceptance level was tested and the result is

significant. All the hypothesized relationship for this study are entirely supported as

proposed.

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CHAPTER 5

DISCUSSION AND CONCLUSION

5.0 Introduction

For this chapter, the overall discussion about the whole research project will be

discussed. Hypotheses proposed will be discussed one by one based on past

researches and possible assumptions of insignificant relationship among variables

will be examined and elaborated in the later part.

Besides, the conclusion of this whole research is presented followed by several

recommendations proposed to marketers in the market. The managerial implications

of this research will be discussed after the limitations and future research is listed in

the earlier parts.

5.1 Discussion on Findings

Table 5.1: Hypotheses and Results

Hypothesis t-stats Decision

H1: There is a positive relationship between

self-esteem and the acceptance level towards

cosmetic surgery.

-0.471

Not Supported

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conformity and the acceptance level towards

cosmetic surgery.

7.016**

Supported


self-accessed attractiveness and the acceptance

level towards cosmetic surgery.

1.594

Not Supported

H4: Gender will affect the relationship between

conformity and acceptance level towards

cosmetic surgery.

60.948** Supported



This research sought to determine the acceptance level of cosmetic surgery among

Gen Y in Malaysia, as well as examine the relationship between the self-esteem,

conformity and self-accessed attractiveness towards acceptance level. The data

indicated that, based on the current sample comprised of diverse ethnic groups and

gender, self-esteem and self-accessed attractiveness has direct influence towards

acceptance level of cosmetic surgery which conformity does. Besides, there were

significant differences in acceptance level of cosmetic surgery across gender and

monthly allowance.

The finding of this research is consistent with the results of the study by Swami and

Premuzic (2009) that had found that acceptance of cosmetic surgery is associated

with participants‘ sex, conformity, self-esteem, self-accessed attractiveness. However,

findings also showed that the acceptance of cosmetic surgery among Gen Y in

Malaysia is low and the mean for the dependent variable of this research is 3.90

which indicated that most of the respondents do not agree and think cosmetic surgery

is a good thing and will not consider of having cosmetic surgery in the future. Overall,

the current participants endorsed the value of cosmetic surgery low and 18.1% of the

respondents strongly disagree about having cosmetic surgery and 22.7% of the

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respondents strongly disagree about consideration for cosmetic surgery in the future.

Current research suggests that a generational effect that reflects a somewhat

narcissistic and hyper-individualized young cohort may influence the degree of

acceptance of cosmetic surgery by participants to enhance their appearances (Twenge,

Konrath, Foster, Campbell & Bushman, 2008).

5.1.1 Findings on the Hypotheses

Relationship between self-esteem and the acceptance level towards cosmetic surgery

H1: There is a positive relationship between self-esteem and the acceptance level


The t-statistic of hypothesis 1 for this research is not significant with a p-value of

2.924 and coefficient correlation of 0.182. This indicates that self-esteem has a

positive and direct relationship towards acceptance of cosmetic surgery and the

relationship is significant at a significant level 95% confidence interval. Hence

hypothesis 1 is not supported.

The decision made indicated that there is no direct relationship between self-esteem

and acceptance of cosmetic surgery. From the findings of this research, we can

understand that the self-esteem level of Gen Y in Malaysia is high with a mean of

5.25 for male and 5.04 for female. This indicates that the target sample of this

research in Malaysia have high esteem with themselves which then having a lower

acceptance towards acceptance level of cosmetic surgery. Results show that 39.2% of

the respondents agree that they have a number of good qualities in them, 32.3% of the

respondents agree that they believe their capabilities to do things are as well as most

other people do and 33.1% of the respondents take a positive attitude towards

themselves. The self-esteem variable scored a mean of 5.14 for this research, which

indicated that Gen Y in Malaysia have high self-esteem within themselves and there

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is not significant relationship between self-esteem value and acceptance level of

cosmetic surgery within this target sample.

Research found that women, or individuals who have lower self-esteem and stronger

appearance concern tends to have higher acceptance of cosmetic surgery (Hender &

Henderson, 2005). However, there is also research stated that low self-esteem was not

correlated with higher likelihood of having cosmetic surgery and accept it (Kvalem et

al., 2006). Tam et al. (2012) mentioned that individuals tend to define cosmetic

surgery as a way or method to reshape a normal structure of body in order to boost

self-esteem and improve appearance, which low self esteem may not be the main

association to influence individuals to have high acceptance of cosmetic surgery.

Moreover, Koff (1998) mentioned that individuals with low self-esteem may

associate with a higher likelihood to go for cosmetic surgery, which tend increase

their acceptance of cosmetic surgery, and individuals who are highly well perceived

about self may have negative interactions with acceptance of cosmetic surgery. There

are studies that pointed out individuals who have high esteem may have a higher

acceptance towards cosmetic surgery (Sarwer et al., 2005). However, from the

understandings of the findings from this research, acceptance level of cosmetic

surgery of Gen Y in Malaysia may be influenced by other factors which are not

studied by this research, hence future research may focus more on other factors such

as body image, big 5 personality test or social influential (Swami et al., 2009).

The variable of self-accessed attractiveness which is not significant when it was

analyzed together with the other variables, is significant again when it was tested

alone with the dependent variable. This may be due to the strongly variation

associated with other variable during the regression analysis which separately regress

the dependent variable and independent variables will make the regression line more

significant (Leech et al., 2005).

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Relationship between conformity and the acceptance level towards cosmetic surgery

H2: There is a positive relationship between conformity and the acceptance level


The t-statistic for hypothesis 2 of this research is 7.016 with a significant value of

0.000, indicating that there is a relationship between conformity and acceptance level

towards cosmetic surgery. Based on the result obtained through the coefficient

correlation, conformity has a positive relationship towards acceptance level of

cosmetic surgery, meaning that the higher the conformity level, the higher the

acceptance level towards cosmetic surgery. The relationship is significant at a

significant level 95% confidence interval, hence hypothesis 2 is supported.

The relationship between this variable and acceptance level of cosmetic surgery is

supported. The mean obtained for this variable is 4.50, indicating that Gen Y in

Malaysia have high conformity in making decision. Conformity is a degree to

determine how dependent an individual is and it can be in the form of social

influential such as friends, family, partner or the current society point of view. For

this research, 28.8% of the respondents agree that they will often rely on and act upon

the advice of others, 25.8% of the respondents agree that they will change their

opinion in order to please someone else, 23.1% of the respondents agree that they

tend to be what people expect them to be in order to get along and be liked and 29.6%

of the respondents agree that they ae careful with their actions. This showed that there

is a high degree of conformity within the target sample which make this variable

more significant to be studied for this research.

This finding is consistent with the findings of Mehrabian (2005) which found that

conformity is expected to associate with the acceptance of cosmetic surgery. Swami

et al., (2008) reported that conformity will strongly affected the social factor which

will have influence on the acceptance level of cosmetic surgery as individuals have a

higher willingness to accept cosmetic surgery in order to satisfy their partners, family

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or closest friends. It can also be said that high conformity within some individuals

indicate that he/she has a higher acceptance to cosmetic surgery as long as it is

perceived as the right thing to do.

Relationship between self-accessed attractiveness and the acceptance level towards

cosmetic surgery

H3: There is a positive relationship between self-accessed attractiveness and the

acceptance level towards cosmetic surgery.

The t-statistic of hypothesis 3 for this research is not significant with a p-value of

3.601 and coefficient correlation of 0.265. All the findings are at a significant level of

95% confidence interval. This indicates that self-accessed attractiveness has a

positive and no direct relationship towards acceptance of cosmetic surgery.

Hypothesis 3 is not supported.

For this research, most of the respondents graded themselves neutral or high attractive

to the others. The responses get from respondents through questionnaire reported that

26.5% of the respondents graded themselves as an attractive person, 23.5% of the

respondents agree that they find their overall body shape is attractive, 24.2% find

their body weight attractive and 29.6% of the respondents agree that their overall

facial is attractive. The overall mean for this variable is 4.44 meaning that Gen Y

involved in this research find themselves attractive to the others.

Previous findings showed that when self-accessed attractiveness is high, the

acceptance towards cosmetic surgery will be influenced and tend to be lower (Eagly,

Ashmore, Makhijani and Longo, 1991). This finding is consistent with the previous

findings stating that prevalent physical attractiveness will cause stereotype in

individuals and hold a negative evaluation towards cosmetic surgery, which then lead

to lower acceptance of cosmetic surgery (Swami et al., 2008). Society emphasize and

perceived the use of cosmetic surgery to enhance one‘s attractiveness and brings

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social rewards to the individual (Davis, 1995), which tend lead to a higher acceptance

of cosmetic surgery when the self-accessed attractiveness is at a lower level.

Researches found that individuals who expected more experiences of sexual body

shame will tend to have consider undergoing cosmetic surgery more in the future

(Calogero et al., 2010). Kozee et al. (2007) mentioned that women who have graded

themselves as lower attractive will closely tied to endorse strategies in order to

improve how attractive they appear to others.

It is concluded that there is not significant relationship between self-accessed

attractiveness and acceptance level of cosmetic surgery for this research. The variable

of self-accessed attractiveness which is not significant when it was analyzed together

with the other variables, is significant again when it was tested alone with the

dependent variable. This may be due to the strongly variation associated with other

variable during the regression analysis which separately regress the dependent

variable and independent variables will make the regression line more significant

(Leech et al., 2005).

Several factor may affect this decision such as the overlapping of variables or the

existence of outliers within the analysis process. Most of the respondents in Malaysia

mentioned that they have lesser desire to change their bodies, hence they will hardly

consider about undergoing cosmetic surgery process (Karupiah, 2012). As Malaysia

is a multi-ethnic and multi-cultural country, hence it make the country to be a rich

environment for research and lots of area need to be handle carefully in order to

satisfy the market. Culture may be one of the factors that influence the relationship

between variables and the demographic provide more areas for further research.

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5.1.2 Moderating Effect of Gender Towards Acceptance Level and Conformity

H4: Gender will affect the relationship between conformity and acceptance level


Multiple linear regression test was carried out in order to test for moderation effect of

gender towards the relationship between acceptance level and conformity, and result

showed that the moderation effect is significant. Amini and Stromsten (2010)

reported that due to different sex may have different practical implications on the

information and norm influences, sex differences is particularly a moderator towards

conformity.

Overall, the findings and discussion provided by and from this research are

significant and useful. Information obtained suggest that objectification theory does

have utility for predicting the acceptance level of individual towards cosmetic surgery,

and it is agreeable that objectification of Gen Y represents a negative context that

influence individual to accept cosmetic surgery and likelihood to go for it.

5.2 Implications on the Study

Based on all the findings of this research manage to get, this study is strongly

believed to provide useful information and solutions to the business in beauty

industry, marketers of the industries involved, consumers who planning to undergo

cosmetic surgery and entrepreneurs who are trying to enter the beauty industry. The

implications of this research are mainly for those cosmetic surgery business that exist

in the market and it allows consumer or wanted to take or already took cosmetic

surgery to have a better understanding about the acceptance of their actions.

All the findings are important for these parties involved as they provide a better

insight about how individuals think about cosmetic surgery. As the research was

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conducted mainly on urban Gen Y, it has strongly represented the current major

spender in the market which provide value information towards the organizations in

beauty industry. This can help to reduce unnecessary advertising or marketing cost

used by business to market to consumers. Moreover, since this research provide a

general acceptance level of cosmetic surgery in the current market, this will boost the

confidence and determination of those consumers who needed or wanted to carry out

cosmetic surgery as they are now aware about how the population perceived about

cosmetic surgery.

5.3 Limitations of the Study

Throughout this research, the researcher identified a few limitations.

First, the research was conducted in a short period of time. Time is significantly an

important element. To ensure that meaningful and valid results could be gained, the

researcher had to scale down the target population. Although this study met the objectives,

it might be better if the researcher is provided with a longer time frame. This research

could then be conducted with a bigger population, such as studying the various service

industry in Malaysia.

Second, the researcher could only conduct the study in Klang Valley of Malaysia due to

time constraint. Questionnaires were only distributed to the targeted respondents,

therefore, the results are limit to the scope of the research which does not represent the

population in Malaysia.

Third, the sample size for this study is relatively small due to insufficient funds and time

constraint. 300 sets of questionnaires were distributed but only 260 sets were collected

back to be used. A sample size that is small leads to higher margin of error and might

render the study meaningless. Sampling errors could affect the interpretation and

precision of the results.

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Lastly, although the results generally showed that gender does moderate the

relationship between conformity and acceptance level, there shall be more moderator

which may influence the relationship between variables. As this research mainly

required respondents to have self-report about their self-esteem value, degree of

conformity and self-accessed attractiveness.

5.4 Recommendations for Future Research

In the view of the limitations mentioned above, there is possible improvement and

recommended solutions to overcome the limitations are composed as below.

First of all, future researches can be conducted by focusing more on the possible

moderators in this area. For example, the body mass index (BMI) may influence how

an individual accessed their own attractiveness, and personality traits such as the Big

5 Personality (Openness, Conscientiousness, Extraversion, Agreeableness and

Neuroticism) may influence one‘s self esteem value and more.

Secondly, future studies are recommended to target respondents from diverse range when

conducting research such as other sectors in Malaysia and locations, for example other

states in Malaysia. A sufficiently large sample size could limit the influence of outliers

and is more representative of the population (Lenth, 2001). In addition, it is important to

create results among significantly different variables. According to Lenth (2001), ―an

under-sized study can be a waste of resources for not having the capability to produce

useful results, while an over-sized one uses more resources than are necessary‖.

Thirdly, it is strongly recommended to have a larger sample size in order to improve the

accuracy of findings. Although it requires greater time commitments and sufficient funds,

larger sample size helps in identifying better results. It also allows the researcher to

determine the outliers more easily as the researcher is substantially studying more

subjects. Hence, if outlier is shown in the sample, increasing in sample size could avoid

misleading results.

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Last but not least, the target sample of this research mainly compromised of working

adults which some students who are also from Gen Y category were overlooked.

Studies shows that 34% of the labour market in Malaysia are made up by Gen Y

whereas the others are at higher education level (Shaliza, Irma and Mohamed, 2015).

Future research may be conducted in order to study the spending behaviours of Gen Y

in universities in order to fully understand and control this booming generation.

5.5 Conclusion

To conclude, the findings of the research have provided several implications in

determining the acceptance level of cosmetic surgery, the degree of self-esteem, the

level of conformity and the self-accessed attractiveness of Gen Y in Malaysia. By

analysing all the data collected from the respondents, the result managed to meet the

basic requirement of a reliable and valid research and answer all the research

questions proposed in the earlier part of this research. From the findings, we

understand that conformity is the only variable in this research that has direct

relationship with acceptance level of cosmetic surgery among Gen Y in Malaysia.

Correlation tests showed that all three independent variables have relationship with

the dependent variable, and gender does moderate the relationship between

conformity and acceptance level. All the research questions and objectives were met.

Based on the findings, it is clearly showed that the level of conformity affects the

acceptance level of cosmetic surgery the most, followed by self-accessed

attractiveness and self-esteem. As major findings indicated that acceptance level of

male in cosmetic surgery tends to be influenced by conformity more than female,

marketers may now target and focus more on marketing and influencing Gen Y male


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APPENDICES

Appendix A - Questionnaire

The purpose of this questionnaire is to examine more about the acceptance level of

Malaysia‘s Generation Y towards cosmetic surgery, and this study is completely

voluntary. Your participation in this study is greatly appreciated. Thanking you in

advance for your participation.

All your responses will remain ANONYMOUS and all the data will be KEPT

PRIVATE and CONFIDENTIAL. This research is conducted mainly for

educational purposes only. Thank you.

This questionnaire consists of 32 questions which may take up 10-15 minutes to

complete. Please answer all of the following questions on the 7-point scale ranging

from 1 (Strongly Disagree) to 7 (Strongly Agree) as per below.

1=Strongly Disagree (SD); 2= Disagree (D); 3=Somewhat Disagree (SD); 4=

Neutral (N); 5= Somewhat Agree (SA); 6=Agree(A); 7=Strongly Agree (SA)

Cosmetic Surgery are procedure and techniques focused on enhancing appearance

whereas Plastic Surgery focused on repairing defects, to reconstruct a normal function

& appearance.

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Part A SD D SD N SA A SA

1 It makes sense to have minor cosmetic

surgery rather than spending years

feeling bad about the way you look.

1 2 3 4 5 6 7

2 Cosmetic surgery is a good thing

because it can help people feel better

about themselves.

1 2 3 4 5 6 7

3 In the future, I could end up having

some kind of cosmetic surgery. 1 2 3 4 5 6 7

4 People who are very unhappy with their

physical appearance should consider

cosmetic surgery as one option.

1 2 3 4 5 6 7

5 I have sometimes thought about having

cosmetic surgery. 1 2 3 4 5 6 7

6 I would seriously consider having

cosmetic surgery if my partner thought

it was a good idea.

1 2 3 4 5 6 7

7 If it would benefit my career I would

think about having plastic surgery. 1 2 3 4 5 6 7

8 I would seriously consider having

cosmetic surgery if I thought my partner

would find me more attractive.

1 2 3 4 5 6 7

9 If a simple cosmetic surgery procedure

would make me more attractive to

others, I would think about trying it.

1 2 3 4 5 6 7

Part B SD D SD N SA A SA

10 On the whole, I am satisfied with myself 1 2 3 4 5 6 7

11 At times, I think I am no good at all. 1 2 3 4 5 6 7

12 I feel that I have a number of good

qualities. 1 2 3 4 5 6 7

13 I am able to do things as well as most

other people do. 1 2 3 4 5 6 7

14 I feel proud of myself. 1 2 3 4 5 6 7

15 I take a positive attitude toward myself.

1 2 3 4 5 6 7

Part C SD D SD N SA A SA

16 I often rely on, and act upon, the advice

of others. 1 2 3 4 5 6 7

17 I would rather be myself than be well

thought of. 1 2 3 4 5 6 7

18 I change my opinion (or the way that I

do things) in order to please someone

else. 1 2 3 4 5 6 7

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19 In order to get along and be liked, I tend

to be what people expect me to be. 1 2 3 4 5 6 7

20 It is important to me that I behave

―properly‖ in social situations. 1 2 3 4 5 6 7

21 If there is any criticism or anyone says

anything about me, I can take it 1 2 3 4 5 6 7

22 I am careful at parties and social

gatherings for fear that I will do or say

things that others won‘t like.

1 2 3 4 5 6 7

Part D SD D SD N SA A SA

23 I think my overall physical

attractiveness is high. 1 2 3 4 5 6 7

24 I find myself overall facial is attractive. 1 2 3 4 5 6 7

25 For me, my body weight and size are

attractive. 1 2 3 4 5 6 7

26 I find my overall body shape or figure is

attractive. 1 2 3 4 5 6 7

27 I am satisfied with my current height. 1 2 3 4 5 6 7

28 I will grade myself as an attractive

person. 1 2 3 4 5 6 7

Part E: Demographic

29) Gender 30) Nationality:

31) Monthly Allowance:

32) Ethnicity:

Male Malaysian

Female Other, please specify:

__________________

RM1000 and below RM 1001 – RM 5000

RM 5001 – RM 10000 RM 10001 and above

Chinese Indian

Malay Others, please specify:

_________________

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I hereby confirmed that the interviewer has explained the study to me and

answered all my questions. I have been told the risk and/or discomforts as well as

the possible benefits of the study. I understand what the study is about, how the

study is conducted and why it is being performed.

I agree to take part in the above research project. I understand my rights as a

research subject and I voluntarily consent to participate in this study. I am free

to withdraw at any time without giving any reason and without there being

negative consequences. In addition, should I not wish to answer any particular

question or questions, I am free to decline.

I agree for the data collected from me to be used in future research.

Subject

Signature : ________________________

Date: ________________________

--- Thank you for spending your time answering our questionnaire. —

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